NPI | 1770540114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 8403) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH 8403) |
Enumeration Date | 2006-04-28 |
Last Update Date | 2008-08-27 |